Frequently Asked Questions on the NHS Workforce Race Equality Standard (WRES)

July 2018

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Guidance

LS2 7UE0113 8251584

Carly StockportWRES Implementation TeamQuarry HouseLeeds

This document presents the frequently asked questions regarding the NHS Workforce Race Equality Analysis. It is intended to help support the understanding and use of the WRES. Further information on the work of the national WRES Implementation Team can be found at: https://www.england.nhs.uk/about/gov/equality-hub/equality-standard/

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Dr Habib Naqvi and Yvonne Coghill

July 2018CCG Clinical Leaders, CCG Accountable Officers, CSU Managing Directors, Care Trust CEs, Foundation Trust CEs , Medical Directors, Directors of PH, Directors of Nursing, Local Authority CEs, Directors of Adult SSs, NHS Trust Board Chairs, NHS England Regional Directors, NHS England Directors of Commissioning Operations, All NHS England Employees, Directors of HR, Directors of Finance, Allied Health Professionals, GPs, Communications Leads, Emergency Care Leads, Directors of Children's Services, NHS Trust CEs, National healthcare bodies, Trades Unions and Royal Colleges, Third Sector Strategic Partners

National healthcare bodies, Trades Unions and Royal Colleges, Third Sector Strategic Partners

WRES Technical Guidance, WRES Equality Analysis

Frequently Asked Questions on the NHS Workforce Race Equality Standard - April 2016

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Frequently Asked Questions on the NHS Workforce Race Equality Standard (WRES) Version number: 3 First published: April 2015 Updated: July 2018 Prepared by: Dr Habib Naqvi and Yvonne Coghill Classification: OFFICIAL The NHS Commissioning Board (NHS CB) was established on 1 October 2012 as an executive non-departmental public body. Since 1 April 2013, the NHS Commissioning Board has used the name NHS England for operational purposes. Other formats of this document are available on request. Please send your request to england.wres@nhs.net

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NHS Workforce Race Equality Standard: Frequency Asked Questions (FAQs)

Q1: Why is the NHS now taking mandatory action to ensure race equality and fair treatment for its black and minority ethnic (BME) workforce? A: The systemic discrimination against Black and Minority Ethnic (BME) staff within

the NHS is highlighted in numerous reports and studies. These show that by every

indicator BME staff have a less favourable treatment and a worse experience of

working in the NHS than other members of staff. This is important not just because

of the costs to those staff and the NHS as a whole of such treatment, but because,

equally importantly, we also know through work done by Professor Mike West and

Professor Jeremy Dawson that there is spiral of positivity in organisations that have

an engaged, motivated and enthusiastic staff. Being undervalued and discriminated

against leads to disengagement, unhappiness, depression, poor performance and

ultimately reduced effectiveness. This is true for everyone but Professor West’s

(2011)1 research shows that:

‘the greater the proportion of staff from a black or minority ethnic (BME)

background who report experiencing discrimination at work in the previous 12

months, the lower the levels of patient satisfaction, the experience of BME

staff is a very good barometer of the climate of respect and care for all within

NHS trusts’.

The NHS Equality and Diversity Council which proposed the Workforce Race

Equality Standard is NOT suggesting other forms of equality are less important but it

is clear that race discrimination is an important issue within the NHS and there has

been little if any improvement in recent years. 17% of NHS staff are from BME

backgrounds, including 20% of nurses and 37% of doctors, and we now know that

tackling their unfair treatment benefits patient care so it is clearly a priority.

1 West, M.

Dawson, J. NHS Staff Management and Health Service Quality, Aston Business School. (2011).

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Q2: What steps has the NHS taken to tackle race inequality in the NHS workforce? A: On 29 July 2014 the NHS Equality and Diversity Council pledged its commitment,

subject to consultation within the NHS, to implement two measures to improve

equality across the NHS, starting from April 2015.

The first was a Workforce Race Equality Standard (WRES) that would, for the first

time, require organisations employing almost all of the 1.4 million NHS workforce to

demonstrate progress against a number of indicators of workforce equality, including

a specific indicator to address the low levels of BME Board representation.

Alongside the WRES, the NHS Equality Delivery System (EDS2) also became

mandatory. EDS2 aims to help organisations improve the services they provide for

their local communities and provide better working environments for all groups. Since

April 2015, the WRES and EDS2 have been included in the NHS standard contract.

The regulators – including the Care Quality Commission – are also using the WRES

as part of their inspection programme to help assess whether organisations are ‘well-

led’.

Q3: Is there a good summary of the case for such an approach? A: There are several. In 2014, NHS Providers, which represents NHS Trusts,

produced a report entitled Leading by example: the race equality opportunity for NHS

provider boards which summarises the case and gives some examples of good

practice.2

Q4: What was the response to the introduction of Workforce Race Equality Standard? A: NHS and patient leaders welcomed the decision to have a Workforce Race

Equality Standard. Simon Stevens, NHS England’s Chief Executive and Chair of the

NHS EDC, said: “We want an NHS ‘of the people, by the people, for the people’.

That’s because care is far more likely to meet the needs of all the patients we’re here 2 Leading by example: the race equality opportunity for NHS provider boards: (2014) http://www.nhsproviders.org/resource-library/the-race-equality-opportunity-for-nhs-provider-boards

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to serve when NHS leadership is drawn from diverse communities across the

country, and when all our frontline staff are themselves free from discrimination.”

Chris Hopson, chief executive of NHS Providers, said: “It is vital that Boards reflect

the diversity of local populations and the NHS workforce. We are keen to ensure that

early progress is made on improving levels of BME representation at Board level and

in senior leadership positions across the NHS.”

Katherine Murphy, Patients Association, said: “Diversity in leadership is associated

with more patient-centred care, improved patient access, experience and outcomes

and higher staff morale, which ultimately is the aim for everyone using and working

across the NHS.”

Q5: How does the Workforce Race Equality Standard complement the NHS Constitution? A: The NHS is founded on a core set of principles and values that bind together the

diverse communities and people it serves – the patients and public – as well as the

staff who work in it. The NHS Constitution establishes those principles and values of

the NHS across England. It sets out the rights, to which all patients, communities and

staff are entitled to, and the pledges and responsibilities which the NHS is committed

to achieve in ensuring that the NHS operates fairly and effectively.

Working for race equality is rooted in the fundamental values, pledges and

responsibilities of the NHS Constitution.3

3 The NHS Constitution for England. Department of Health (2013)

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/170656/NHS_Constitution.pdf

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Q7: What are the nine Workforce Race Equality Standard indicators? A: The focus and wording of nine indicators have been subject to extensive engagement since 2014. The latest (2018) indictors are below:

Workforce indicators For each of the four workforce indicators, compare the data for white and BME staff

1. Percentage of staff in each of the AfC Bands 1-9 or medical and dental subgroups and VSM (including executive board members) compared with the percentage of staff in the overall workforce disaggregated, if appropriate, by:

• Non-clinical staff • Clinical staff, of which

- Non-medical staff - Medical and dental staff

2. Relative likelihood of staff being appointed from shortlisting across all posts

3. Relative likelihood of staff entering the formal disciplinary process, as measured by entry into a formal disciplinary investigation

4. Relative likelihood of staff accessing non-mandatory training and CPD

Staff survey indicators (or equivalent) For each of the four NHS staff survey indicators, compare the outcomes of the responses for white and BME staff

5. Percentage of staff experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 months

6. Percentage of staff experiencing harassment, bullying or abuse from staff in last 12 months

7. Percentage believing that trust provides equal opportunities for career progression or promotion

8. In the last 12 months have you personally experienced discrimination at work from a manager, team leader or other colleagues

Board representation indicator For this indicator, compare the difference for white and BME staff

9. Percentage difference between the organisations’ board membership and its overall workforce disaggregated:

• By voting membership of the Board • By executive membership of the Board

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Q8: How can the Workforce Race Equality Standard be summarised? A: The WRES is being implemented to gauge the current state of workforce race

equality within NHS organisations and track what progress is being made to identify

and promote talented BME staff as well as helping to eliminate wider aspects of

discrimination in the treatment of BME staff.

The WRES takes a small number of indicators and requires NHS organisations to

close the gap between the BME and white staff experience for those indicators.

Organisations will be expected to do what the best ones already do, to scrutinise and

understand the data and act on it, and then work towards a level playing field where

the treatment of staff is not unfairly affected by their ethnicity.

All NHS organisations covered by the NHS standard contract are expected to collect

this data as many already do and are now be required to do what many NHS

organisations do not currently do, that is, to analyse the data and work out how to

reduce the differences in treatment for which there is no objective justification.

Some organisations have already made strides in doing this and it shows in their

data. Others are starting on this journey. The WRES requires all organisations to

collect such data, and to analyse and act on it, seeking to narrow the metrics gap

between the treatment of BME and white staff.

The second part of the WRES concerns data that is already published in the NHS

national staff survey and which considers the differences between the white and

BME staff responses on four indicators.

Finally, organisations are expected to consider whether their board membership is

broadly representative of the overall workforce and this is explained further in the

WRES Technical Guidance.

Q9: How does the Workforce Race Equality Standard work? A: In its simplest form, the WRES gives local NHS organisations the tools to work out

their workforce race equality performance, including BME representation at senior

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management and board level. The WRES exposes differences between the

experience and treatment of White staff and BME staff in the NHS. It enables

organisations to focus on:

How good they are now

How good they should be

How they can get there

There are nine indicators. Four of the indicators focus on workforce data, four are

based on data from the national NHS Staff Survey questions, and one indicator

considers the representativeness of the organisation’s board. NHS organisations

analyse their performance against the nine indicators and use the results to develop

action plans to make continuous improvements. At the heart of the WRES are nine indicators. The indicators cover the things that

research and evidence tells us matter the most to NHS staff.

Q13: What are the implications for NHS organisations? A: Firstly, NHS organisations will have to do what they are already required to do

because of their public sector Equality Duty (PSED). NHS organisations have

historically had a poor record in collecting, analysing and publishing data on equality,

including on race equality.

Secondly, there will need to be a discussion with their commissioners to ensure that

each organisation is collecting, analysing and publishing the data and to establish the

base line data on each indicator. For NHS Trusts this will include the relevant NHS

staff survey data – the staff survey data will be the last published data4.

For other organisations, the WRES will include equivalent survey data alongside

workforce data. Each organisation will need to decide how it is going to narrow the

gap in the metrics between its own White and BME staff in the next year so that it

can demonstrate to its local commissioner, to staff and its Board, and to the CQC,

4 The latest NHS Staff Survey 2014 http://www.nhsstaffsurveys.com/Page/1006/Latest-Results/2014-Results.

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that it is making progress. What that rate of progress is expected to be will be agreed

locally, published, and inspected against.

Q14: Will it involve extra work for NHS organisations that are already hard pressed? A: The collection and analysis of data on workforce race equality should involve no

more work than is currently undertaken. Where the collection of data requires

significant additional work it is likely that such organisations had not been addressing

the issue of race equality sufficiently thoroughly.

What may require more work in understanding the data and listening to staff so that

effective strategies to improve outcomes against these indicators can be reached?

It is intended that considerable effort will be made to ensure good practice is shared

nationally.

EDS2 and the WRES will complement each other, since EDS2 complements WRES

data, and the WRES data can feed into EDS2 evidence. Both processes help

organisations to identify the equality issues to be address and the means to address

them.

Q16: What about commissioners such as CCGs? A: CCGs should commit to the principles of the WRES and apply as much of it as

possible to their own workforce. In this way, CCGs can demonstrate good leadership,

identify concerns within their workforces, and set an example for their providers.

Formally, of course, CCGs are not required by the NHS standard contract to fully

apply the WRES to themselves as some CCG workforces may be too small for the

WRES indicators to either work properly or to comply with the Data Protection Act.

However, all commissioners of NHS services, including CCGs, are expected to have

“due regard” to using the WRES to help improve workplace experiences and

representation at all levels for their own BME staff.

The key case law principles related to the term “due regard” are commonly referred

to as the Brown Principles and are often used to determine whether a public body

has shown “due regard” to the Equality Duty. These principles have been drawn

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upon to underpin the approach commissioners of NHS services, including CCGs,

should take to the application of the WRES to their own organisations. Annex A

presents alignment between the Brown Principles and implications of “due regard” for

WRES use by CCGs.

“Due regard” in this context refers to the CCG giving proportionality, relevance and

sufficient attention to implementing the WRES. Indeed, the workforce of some CCGs

will be too small to carry out the calculations on their staff without the risk of deriving

person identifiable data as the outcome. Indeed, the CCG is recommended to

implement as many of the WRES Indicators are appropriate, whilst giving fair

consideration to the principles of the WRES within their day-to-day activities.

However, in these situations, the CCG can aggregate data to such an extent that

individuals cannot be readily identified, and/or a group of neighbouring CCGs may

want to produce a joint WRES report and work together on an agreed action plan to

improve on the WRES indicators over time. The WRES team will be looking into

these possibilities going forward.

Q17: What about other workforce equality strands? A: The NHSEquality and Delivery Council (EDC) made it clear that there are other

challenges on equality to be met across the range of protected characteristics. The

EDC is committed to promote equality for all, ensuring no one is left behind, and will

ensure that patient, service user and carer perspectives are central to its work. It also

plans to continue with existing work strands and initiate work to advance equality for

other groups protected by the Equality Act. The Workforce Race Equality Standard is

the first phase in a programme of work focussing upon workforce equality. Parallel

work on gender and disability and the workforce has started.

One issue highlighted at the discussion, amongst others, was the treatment of staff

with disabilities since available data suggests serious discrimination, similar in many

ways to that against BME staff takes place. Although the Standard focuses on the

treatment of BME staff, research shows that how all staff are treated impacts on

patient care so further initiatives are planned across other protected characteristics.

That does not prevent individual organisations continuing to develop work now

around other equality strands and it is anticipated that by making sure one strand is

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addressed in such a direct way it will encourage all organisations to focus more

carefully on equality across the board.

NHS England is promoting a number of initiatives to address other protected

characteristic including, in the first instance, supporting additional research and work

on sexual orientation, disability and gender. The Equality Delivery System – EDS2

seeks to focus on all protected characteristics, and a number of specific initiatives of

other equality strands as well as race are underway or planned. If successful, the

approach used for the Workforce Race Equality Standard may be adapted for other

equality strands.

Q18: What are the links between the Workforce Race Equality Standard and the Equality Delivery System – EDS2? A: The Equality Act 2010 ascribes protection to nine characteristics. The nine

characteristics are: age; disability; gender re-assignment; marriage and civil

partnership; pregnancy and maternity; race (including nationality and ethnic origin);

religion or belief; sex; sexual orientation.

The Equality Delivery System (EDS2) is designed to help local NHS organisations, in

discussion with local stakeholders, review and improve their performance for

patients, communities and staff in respect to all characteristics protected by the

Equality Act 2010.

The WRES seeks to tackle one particular aspect of equality – the consistently less

favourable treatment of the BME workforce - in respect of their treatment and

experience. It draws on new research about both the scale and persistence of such

disadvantage and the evidence of the close links between discrimination against staff

and patient care.

The WRES and EDS2 are complementary but distinct. The indicators used in the

WRES, and the progress made in closing them, will assist organisations

implementing the EDS2. Though the progress reports on the Standard and EDS2 will

be made separately, local NHS organisations will want to check how the data

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published for the Standard can assist and align with EDS2, and in particular with the

outcomes under EDS2 Goals 3 and 4.

Goal 3: A representative and supported workforce – notably EDS2 outcomes:

• 3.1 – Fair NHS recruitment and selection processes lead to a more

representative workforce at all levels

• 3.3 – Training and development opportunities are taken up and positively

evaluated by all staff

• 3.4 – When at work, staff are free from abuse, harassment, bullying and

violence from any source

• 3.6 – Staff report positive experience of their membership of the workforce

Goal 4: Inclusive leadership – notably EDS2 outcomes:

• 4.1 – Boards and senior leaders routinely demonstrate their commitment to

promoting equality within and beyond their organisations

• 4.3 – Middle managers and other line managers support their staff to work in

culturally competent ways within a work environment free from discrimination

Both the WRES and EDS2 will assist organisations in meeting their Public Sector

Equality Duty requirements.

It will be for local organisations to decide if the reporting dates for EDS2 and the

WRES are the same, but if they are the reports should be made separately. Further

information on the see Equality Delivery System – EDS25

Q19: Isn’t the WRES too much like micromanagement of local employers? A: If an entirely voluntary system was enough to have made the progress needed,

then we would have surely seen more progress ten years after the 2004 Race

Equality Action Plan launched with Ministerial backing. It is clear that more of the

same will not be enough.

5 The Equality Delivery System. A refreshed Equality Delivery System for the NHS – EDS2. NHS England 2013. EDS 2 information :http://www.england.nhs.uk/ourwork/gov/equality-hub/eds

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This proposal is intended to focus employers’ attention on this issue with the intention

that “the rest will be as good as the best”. Lots of effort will hopefully go into

encouraging and spreading good practice. But based on the experience of the last

decade there may well be employers who will not prioritise this until it becomes part

of the commissioning process with measurable, published, outcomes and the back

stop of the regulators.

The evidence linking fair treatment of the 17% of NHS staff who are BME staff to

improved care for patients is clear, as is the case for a more diverse leadership

benefitting patients. So making this initiative work is in everyone’s interest.

Q20: Will the WRES cost extra time or money? A: There are three steps involved in meeting the standard. The first step is to ensure

the appropriate data is being collected. All organisations, in accordance with the

Public Sector Equality Duty (PSED) should be doing this across all protected

characteristics. Those Trusts using the Equality Delivery System – EDS2 may well be

collecting the data as part of EDS2, but up until now, there has been no mandatory

requirement to do so.

The second step is to analyse and publish the data. Again the PSED requires

organisations to do this and the data that the Standard considers is certainly data

that any organisation wishing to make progress on equality should be collecting this

across all protected characteristics. Organisations that use EDS2 may well be doing

this already but up until now, there has been no mandatory requirement to do so.

However the evidence of research is that too many Trusts are not yet analysing and

publishing data.

For these two steps there will either be no extra cost or it is a cost they should

already be incurring if they are to address inequality.

The third step is to act on the analysis and take steps to close the gap between the

treatment of white and BME staff. This requires a determined effort to target those

areas where there is a substantial gap, for example, on recruitment/promotion,

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access to non-mandatory training, bullying and discipline. That must involve BME

staff and staff organisations. This will cost staff time and possibly some external

assistance but there are benefits too.

NHS Employers have highlighted the considerable cost of not being an equality

employer6. The benefits will include less grievances, more likelihood of attracting

and appointing the best staff, less bullying, less disciplinary cases, less turnover and

sickness absence, and more importantly of all, better BME staff morale with benefits

for all patients. There may be upfront costs but real benefits in the short to medium

term.

Q21: What consequences will there be for service providers that fail to move to meet the WRES? A: Unlike previous NHS initiatives on equality, this requires published measurable

outcomes that are difficult to “game”. Is it hoped that many (most) organisations will

adopt the strategy of closing the gap between White staff and BME staff experiences

because they want to, in the interests of patients and their staff. For those who don’t

there are three consequences.

Providers will need to confirm to commissioners in an Annual Report what progress

they have made against the WRES. Failure to do so will be a breach of the NHS

Standard Contract and should trigger robust discussions about how and why, and

what steps will be taken to improve performance the following year. Ultimately a

breach of a contract should be dealt with as any other breach of contract.

The progress made by trusts will be published and, as with much other data, will be

available nationally in a form that enables organisations to benchmark themselves. It

is likely that as well as encouraging trusts to do better, to find “buddying”

arrangements and good practice, a poor performance will trigger Board level

discussions.

6NHS Employers (2014). The business case for diversity. http://www.nhsemployers.org/SharedLearning/Pages/BusinessCaseForDiversity.aspx.

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When regulators adopt progress towards the WRES as an element of their scrutiny

from April 2015 onwards, then failure to progress on the WRES is likely to be taken

into account in determining whether the trust is “well led” or not, with the normal

range of consequences for the board.

Q22: What exactly is the CQC’s role? A: The WRES is designed to prompt, and where necessary require, inquiry and root

cause analyses of the differences in the WRES indicator data for BME and White

staff. The WRES indicators are difficult to ‘game’ and the cultural challenges that the

WRES unearths (bullying culture, blame culture, ‘club’ culture) are ones that all

organisations proclaim they wish to tackle in the interests of patient outcomes and

organisational performance. Inclusion of the WRES in Care Quality Commission

(CQC) inspections is therefore appropriate and necessary.

From April 2016 onwards, progress on the WRES will be considered as part of the

“well led” domain in CQC’s inspection programme for all NHS trusts and independent

healthcare providers contractual obliged to carry out the WRES. In 2015-16 the CQC

piloted its approach to using the WRES in a number of their comprehensive

inspections of NHS Trusts and independent healthcare providers. In particular, the

organisation’s completed WRES Reporting Template and accompanying action plan

were analysed as part of the evidence used in the inspections. Providers inspected

are also asked how they were addressing any issues arising from their respective

WRES data and a variety of methods were tested to engage BME staff – so the data

is ‘triangulated’ by qualitative findings from both providers and employees.

The following initiatives have been underway to support the CQCs use of the WRES

as part of the inspection process:

• Recruitment of Equality and Diversity ‘specialist advisors’ who can assist with

the assessment of the WRES and other equality and diversity issues for

patients or staff, as part of the CQC inspection team during inspection visits.

• Production of short pre-inspection WRES briefings based upon the WRES

data, and other relevant workforce race equality evidence, for the trusts being

inspected. The briefings will aid CQC inspectors and be a useful source of

reference during their inspection visits.

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• Ongoing training and development for CQC inspectors and the recruited

Equality and Diversity ‘specialist advisors’ – providing the necessary guidance,

skills and knowledge required to undertake the WRES related element of the

‘well-led’ domain assessment.

Q23: How will BME staff be involved in the process? A: It is essential that the voice of BME staff is heard loud and clear through the

process of identifying the challenges individual organisations face in meeting the

WRES. Organisations are strongly encouraged to help establish and support BME

networks of staff as an important source of knowledge, support and experience. Such

work may well include providing a safe place for BME staff to share their concerns

and be listened to.

An increasing number of trusts are recognising the importance of giving time and

facilities to BME staff groups and a serious opportunity to engage with Board. In ‘best

practice’ trusts, the CEO or Chair meet with, and listen to the concerns of, BME staff

in a “safe space”.

Q24: What is the role of trade unions? A: To succeed in successfully implementing the WRES, it will be essential to engage

with staff and their recognised trade unions. Organisations are more likely to

successfully engage with staff and improve the impact of work, where the

implementation of the WRES, and other equality initiatives such as EDS2, involve

local social partnership with trade unions and staff organisations, to help draw on

their knowledge, support and experience. Q25: Who should lead on the WRES within organisations? A: A report on equality and diversity published by NHS Providers7 states:

“Our key message is that real and sustained change will only be made by

determined board leadership and commitment. It requires a shift beyond an

over-reliance on diversity managers and HR directors to drive change. In

short, it means the whole board leading by example and championing race

7 NHS Providers Booklet http://www.nhsproviders.org/resource-library/the-race-equality-opportunity-for-nhs-provider-boards/

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equality not to comply with a newly imposed standard, but as a strategic

opportunity to demonstrate their commitment to diversity and to leverage its

potential to improve patient care”

The Technical Guidance on WRES suggests that organisations will want to nominate

a board member to lead work to meet the WRES, and other aspects of equality work,

as some NHS trusts do now.

Q27: Has there been an Equality Analysis of the WRES? A: An Equality Analysis8 on the WRES has been completed and will be continuously

reviewed and updated as required.

Q28: How were the definitions of “BME and white” decided and why? A: The definitions of “Black and Minority Ethnic” and “White” used have followed the

national reporting requirements of Ethnic Category in the NHS Data Model and

Dictionary, and as used in Health and Social Care Information Centre data. “White”

staff includes White British, Irish and Any Other White. The “Black and Minority

Ethnic” staff category includes all other staff except “unknown” and “not stated.”

To define BME employers should exclude A, B, C and Z from current values in the

table below. Also exclude 0 and 9 from the old values of which there are around 500

records. Exclude all ‘NULL’ values. The category C ‘Any other white

background’ contains minority groups including white European.

Ethnic Categories as per Office of National Statistics (ONS) 2011 A – White -British B – White -Irish C – Any other white background D – Mixed White and Black Caribbean E – Mixed White and Black African F – Mixed White and Asian G – Any other mixed background H – Asian or Asian British -Indian J – Asian or Asian British -Pakistani

8 WRES Equality Analysis (EA) http://www.england.nhs.uk/ourwork/gov/equality-hub/equality-standard/

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K – Asian or Asian British - Bangladeshi L – Any other Asian background M – Black or Black British -Caribbean N – Black or Black British -African P – Any other Black background R – Chinese S – Any other ethnic group Z – not stated Note: a more detailed classification for local use if required is contained in Annex 2 of DSCN 02/2001. Old Ethnic Codes - staff employed after 1 April 2001 must have their ethnic group assessed and recorded using the new categories and codes as detailed above. 0 – White 1 – Black – Caribbean 2 – Black – African 3 – Black – Other 4 – Indian 5 – Pakistani 6 – Bangladeshi 7 – Chinese 8– Any other Ethnic Group 9 – Not given

Q30: How does the WRES apply where small numbers of BME staff are employed? A: There are a small number of organisations where there is either so small a

number of BME staff that it is difficult to publish data without identifying individuals, or

where the numbers of BME responses to the staff survey are too low to merit

publication without potentially identifying individuals.

The presence of small number of BME staff does not mean that there may not be

similar issues around the treatment and experience of BME staff as compared to

organisations with larger numbers of BME staff – with implications for patient care. It

does mean there may need to be some flexibility about how commissioners seek

assurance that the WRES is being met and how the CQC inspect against the WRES.

Further advice on this will be provided in due course.

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Q32: How will the WRES apply to national NHS bodies? A: National bodies include (but not exclusively):

• NHS England

• The Care Quality Commission

• NHS Improvement

• NHS Digital

• Public Health England

• Health Education England

These bodies are members of the Equality and Diversity Council and have committed

themselves to the support of the WRES. They are applying the WRES provisions to

themselves, and the WRES data for the above six ALBs was published in March

2018.9

Q33: How will the WRES apply to independent healthcare providers? A: Implementation of the WRES also applies to all independent provider

organisations that provide NHS services.

Many of the independent provider organisations have a national footprint, and some

provide specialist services; however, the issues covered by the WRES, relating to the

experiences of the workplace and representation at senior management and Board

level for BME staff are as pertinent to non-NHS organisations as they are to NHS

bodies.

Independent provider organisations do not have a similar level of uniformity in the

structure of staff bandings and electronic staff records as is the case within NHS

organisations. Furthermore, independent providers will not be undertaking the NHS

Staff Survey. In implementing the WRES, independent providers should focus upon

their equivalent staff bandings, HR systems and electronic records, and relevant

questions from surveys of their workforce. Indeed, a more tailored approach may be

needed to support WRES implementation and use within the independent provider

sector.

9 https://www.england.nhs.uk/about/equality/equality-hub/equality-standard/2017-data-analysis-report-for-national-healthcare-organisations/

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From April 2016 onwards, progress on the WRES will be considered as part of the

“well led” domain in CQC’s inspection programme. This will cover all NHS trusts and

independent healthcare providers that are contractually obliged to carry out the

WRES.

Q35: Why the term “relative likelihood” has been chosen for WRES indicators 2 and 3? A: It has been chosen because it is the most reliable and informative way of

understanding the relative disadvantage of BME staff compared to white staff. How it

is calculated for each metric is shown in the WRES Technical Guidance. 10

Q36: How was the wording of WRES indicators 5 to 8 been chosen? A: The wording is taken exactly from the NHS national staff survey questions that are

referred to in each metric. Precisely what those words mean and how to best

understand the data they reveal is explained in the WRES Technical Guidance.

Q37: How is an organisation’s progress on meeting the WRES be verified? A: The organisation’s progress on meeting the WRES can be verified in three ways.

Firstly, CCGs and other commissioners check, as part of their assurance in respect

of the NHS standard contract which providers are complying with the requirements of

the WRES. Secondly, from April 2016 provider progress on meeting the WRES is be

included in the CQC “well led domain”. Thirdly, all data required to demonstrate

progress in meeting the WRES is published. It is published so that all staff can

scrutinise progress, including local BME and staff side organisations. It is published

for commissioners to consider, and because the CQC expect to be provided with the

data.

In addition, work has been commissioned to determine a robust way of

benchmarking the data for wider comparison to enable organisation to compare

themselves with similar organisations and their progress.

10 https://www.england.nhs.uk/about/equality/equality-hub/equality-standard/resources/

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More generally, organisations covered by the WRES are strongly encouraged to be

open at all stages of engagement with WRES. This means:

• Being open about the nature and scale of the challenge each organisation

faces – sharing data however uncomfortable it may be initially

• Sharing with staff the approaches proposed and inviting real engagement

about those processes

• Publishing to all staff the data from workforce analysis and staff surveys which

indicates challenges around race equality

• Sharing progress and achievements and learning from how progress was

made

Further advice on how the progress for each organisation will be published and work

towards a benchmarking process will follow.

Q38: What does “non-mandatory training” include as this is currently not defined or measured in the same way across different organisations? A: “Non-mandatory training and Continuing Professional Development (CPD)” means

any training or CPD that is not a requirement of the post. Examples of mandatory

training would include lifting, first aid, required professional updating and any other

statutory or contractually required training.

“Non-mandatory training” means, in this context, training that is not a statutory or

contractual requirement and which might reasonably be deemed to assist career or

personal development, including continuing professional development. It would

include, for example, any externally organised course or activity (such as attendance

at conferences) where a place has been booked and paid for that might reasonably

be deemed to assist career or personal development, including continuing

professional development. It would also include externally organised activities which

are NOT paid for as well as a range of other development courses and activity -

including relevant study leave and mentoring – which are supported by the employer

and where appropriate payment by the employer and paid study leave is agreed.

“Accessing” courses and CPD in the context means courses on which places were

offered and accepted.

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It is acknowledged that precisely how organisations define “non-mandatory training”

may vary significantly between organisations, potentially making comparisons

between organisational Indicators difficult. However, each organisation is expected to

be consistent in how they define it year on year.

Employers will also note that each profession is regulated and assessed differently

and that will need to be considered in the application of this standard.

Q39: What is the purpose of using an indicator for staff experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 months? A: Bullying and harassment by members of the public is a problem across the NHS,

especially in certain departments (notably A and E) and in certain types of services

(notably in mental health and ambulance Trusts). It was felt that where there were

significant differences between BME and White experience it was important to

highlight these, especially as in some trusts there is little difference and in others very

significant differences between white and BME experience

Q41: Will WRES indicator 3 be adjusted to take into account that relatively small numbers may be involved in any one year? A: In previous years many organisations have suggested they cannot draw any

conclusions about a pattern of disciplinary action being potentially discriminatory

because the numbers are relatively small.

To avoid that situation Indicator 3 will be calculated over a two year rolling period i.e.

the last two years for which data is available. In some cases the number may still be

small but that does NOT preclude conclusions being drawn especially as the pattern

may be similar over even earlier years.

Q42: How can I submit WRES data for my organisation?

A: The completed template will be submitted through the Strategic Data Collection

Service (SDCS) which replaces Unify 2. NHS Digital will contact the WRES data

submission lead for each NHS trust, with instructions on how to submit your

completed template via SDCS.

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Q46: Do we include staff with unknown or null ethnic categories?

A: Yes. The prepopulated figures are broken down by White, BME and Ethnicity

Unknown/Null. Trusts are encouraged to come up with a strategy to minimise the

number of unknowns/nulls and increase ethnicity self-reporting.

Q48: How are the medical and dental sub categories defined?

A: The grade code is used to look up against the medical & dental sub category of

each medical staff. This lookup matrix is used nationally

Q53: Will the General Data Protection Regulation (GDPR) affect WRES submissions and reporting going forward?

A: GDPR does not materially affect submission, reporting and publication of WRES

data. All information governance (IG) related queries should be discussed with your

local IG Team in the first instance.

Q54: What national support will be available to organisations? A: NHS England has established a national WRES Implementation Team to help

support the use of the WRES within the NHS. Discussions are underway to ensure

that good practice is shared between NHS organisations in as systematic a manner

as possible. Individual HR, equality and trade union networks may also share

examples of good practice that will assist organisations in meeting the WRES. A

dedicated web page has been set up to share news and developments:

https://www.england.nhs.uk/about/gov/equality-hub/equality-standard/